Ageing skin

‘Liver spots’ (‘age spots’)
‘Liver spots’ are like large freckles on the backs of the hands. They are sometimes also called ‘age spots’, but the medical term is solar lentigines. They may be up to 1 cm across in size. They are very common after middle age and are caused by exposure to the sun, which accounts for the word ‘ solar’ in their medical name).

Preventing age spots. To prevent age spots, you need to use an SPF 15–20 sunscreen on the backs of your hands, but by the time you are bothered by them, it is too late. However, using sunscreen should help to prevent new ones occurring.

Selenium is an antioxidant chemical found in Brazil nuts, fish and kidney. Some people think that selenium prevents age spots, but there is no scientific evidence for this.

Getting rid of age spots. If you are very self-conscious about age spots on your hands, you could try 0.1% tretinoin cream (related to vitamin A), for which you need a doctor’s prescription. It can cause irritation. If it does, use it less frequently (every other day, or every third day), or ask your doctor for a weaker cream. However, tretinoin will probably not make the age spots disappear completely; a study published in the Archives of Dermatology (1991;127:666–72) showed that it faded them by about 37%.

Some anti-ageing hand creams now contain retinol, a natural form of vitamin A, similar to tretinoin. The concentration in these creams varies, and they are likely to be less effective than the 0.1% tretinoin cream, but less likely to irritate your skin.

Occasionally, large age spots can be treated by laser or chemical peels.

Suspicious-looking spots
Ask your doctor to check any dark spot that enlarges, changes colour, becomes itchy or bleeds. This is to make sure that it is not a melanoma cancer.